Srilekha Saha

Impact of Isokinetic training on pain in patients’ with Knee osteoarthritis-A Meta-analysis

The incidence of osteoarthritis has been alarming over the years due to increase in the proportion of the aged people. Osteoarthritis has been commonly found to affect the knee joint, the most important joint in the context of weight bearing function of the lower limb. Cartilage destruction and subchondral bone erosion along with other entities affecting the entire structure of the knee are associated with osteoarthritis. Isokinetic training has been used to train athletes and to measure the function of the muscles for almost 5 decades. It has found its application in assessment and training of patients with various disorders. Osteoarthritis of knee is one such disorder where the application of the isokinetic training has been increasing over the years. There have been controversies over the effect of isokinetic training in patients with osteoarthritis of knee. Hence the magnitude of the effect of isokinetic training on functional parameters in patients with osteoarthritis of knee needs to be evaluated. A thorough online literature search was done on Web of Science, ProQuest, PubMed, Ebscohost, CINAHL between 1990 and 2014. Ten articles measuring the effect of isokinetic training on osteoarthritis of knee were included and methodologically assessed. Data from the trials were extracted based on the demographic characteristics, outcomes measured, isokinetic training protocol and the other interventions used. Standardized effect sizes with 95%confidence interval (CIs) were calculated from the preintervention and post intervention means of the isokinetic training group and other intervention group. About 10 studies were included in the review and 9 articles were analysed for reduction in pain. Isokinetic training was not so beneficial in reducing the pain associated with osteoarthritis. Since there was so much of heterogeneity among the studies the result of the analysis should be inferred with caution. Yet there is no definitive evidence to confirm the effects of isokinetic training on osteoarthritis of knee.

Effect of isokinetic training on quadriceps muscle strength in osteoarthritis of knee

The aim of the present study was to investigate the role of Isokinetic Training and Electromyography biofeedback training in improving strength of the quadriceps femoris in participants with Osteoarthritis of knee. Fifty four participants (male and female) in the age range of 50–63 years with knee Osteoarthritis of Grade II and III (Kellgren-Lawrence criteria) severity were recruited from the Department of Orthopedics, Hospital Universiti Sains Malaysia. The selected participants were taken to the Exercise and Sports science laboratory and the laboratory of School of Medical Sciences, Universiti Sains Malaysia for baseline assessment. Extent of muscle strength was assessed employing the isokinetic device BIODEX 4 System Pro. On completion of the baseline assessment the participants were randomly categorized into three groups (Gr.) (Viz. Gr. A, Gr. B, Gr. C and Gr. D) and thus each group consisted of 18 participants. Gr. A participants received Conventional Physiotherapy consisting of strengthening exercises; stretching exercises and range of motion exercises. Gr. B received Isokinetic Training at velocities of 90° and 150°/second. Gr. C participants received EMG Biofeedback training with Mega ME 6000 device. All the interventions were imparted for 25–30 minutes per session; 2 sessions per week for10 weeks (20 sessions). Mid intervention assessment was done after 5th week followed by the post intervention assessment after 10th week following baseline assessment protocol. After the post intervention assessment, the participants were instructed not to attend the training session for the next 8 weeks and not to get engaged in any sort of physical training, exercise or sport programme. The issue of sustainability was also verified by the post-follow-up assessments of the all of the variables following identical assessment protocols after 14th and 18th week of completion. Repeated measure of ANOVA revealed that, Isokinetic Training was beneficial in enhancing muscle-strength of quadriceps femoris (p<.05).

Effectiveness of neuromuscular training program in young athletes suffering from lower lateral ankle ligament injury

The perception and execution of musculoskeletal control and movement are mediated primarily by the central nervous system and involve the integration of three main subsystems: somatosensory, vestibular, and visual. Balance performance and its measurement are influenced by these sub-systems. This present study was carried out to investigate the effectiveness of neuromuscular-controlled training exercises, comprising BOSU-ball balance training and conventional physiotherapy exercise training protocols, in terms of stability, balance, and proprioception in athletes diagnosed with lateral ligament injury of the ankle joint. The Y Balance test was used as a reliable and valid tool for quantitative balance assessment. Thirteen players (aged between 19 to 26 years, Mean age = 23.2; SD = 2.46) suffering from grade II & grade III lateral ligament injury were recruited from the OPD of the department of Orthopaedics of the Hospital of Universiti Sains Malaysia. All participants were subjected to pre-intervention or baseline assessments consisting of a of Y-balance test and assessment of proprioception employing Biodex 4 Isokinetic Equipment. Participants were then introduced to 12 sessions of a neuromuscular controlled training program (30 min/day; 2 days/wk. for 6 wk.). Findings of the study revealed that six weeks of neuromuscular exercises training significantly improved balance, with certain significant aspects of proprioception observed among young athletes diagnosed with ankle lateral ligament injury.